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Platelet Response to Caplacizumab in the Treatment of Acquired Thrombotic Thrombocytopenic Purpura

Recruiting
Conditions
Acquired Thrombotic Thrombocytopenic Purpura
Interventions
Registration Number
NCT05876221
Lead Sponsor
University of Cologne
Brief Summary

The interpretation of platelet counts has to be revaluated in the light of caplacizumab. By effectively blocking platelet binding sites on VWF-multimers, the nanobody leads to a rapid normalization of the platelet count within 3 to 4 days. Most importantly, caplacizumab uncouples platelet counts from ADAMTS13 activity and thereby launches unprecedented thrombocyte dynamics, with potential pitfalls for over- and undertreatment.

A relevant number of patients responds to caplacizumab with a brisk increase in platelet count, followed by a marked dip of platelets (patient on the left). This may mislead treating physicians into re-intensifying therapy, with a respective risk for adverse side-effects and complications. Taken together, these observations call for reliable descriptions and the identification of predictive parameters to predict the platelet response upon administration of caplacizumab in a large patient cohort. Here, PREDICT-2020 is designed as a retrospective study to specifically address the following aspects:

* Identifying and describing clusters of platelet responses to caplacizumab

* Identifying potential pitfalls for treating physicians

* Predicting the individual thrombocyte response

* Correlating platelet responses with individual patient outcome

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
160
Inclusion Criteria
  • Confirmed diagnosis of autoimmune thrombotic thrombocytopenic purpura
  • Treatment with at least a single dose of caplacizumab, either i.v. or s.c.
  • Male or female patients older than 18 years of age
Exclusion Criteria
  • Hereditary thrombotic thrombocytopenic purpura

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
aTTP-PatientsCabliviPatients with immune Thrombotic Thrombocytopenic Purpura, who have been treated with caplacizumab (Cablivi®)
Primary Outcome Measures
NameTimeMethod
Reliable description and prediction of platelet responses to caplacizumabEnrollment

Reliable description and prediction of platelet responses to caplacizumab employing mathematic modelling algorithms

Secondary Outcome Measures
NameTimeMethod
Determination of different clusters of platelet responses to caplacizumabEnrollment

It will be hypothesized the existence of different clusters of caplacizumab responders during the first weeks of therapy, when ADAMTS13 activity typically is still \<10%. A detailed cluster analysis and description of thrombocyte responses to caplacizumab in a large cohort will reliably identify these different responders

Risk stratification of iTTP patients based on their platelet response to caplacizumabEnrollment

Description: Predicting the individual thrombocyte response to caplacizumab improves risk stratification of iTTP patients after initiation of caplacizumab therapy. An early risk stratification allows an optimal timing of monitoring intervals during the first weeks after diagnosis, which are often critical

Correlation of platelet responses to caplacizumab with patient outcomeEnrollment

It will be hypothesized the existence of different clusters of caplacizumab responders during the first weeks of therapy, when ADAMTS13 activity typically is still \<10%. A detailed cluster analysis and description of thrombocyte responses to caplacizumab in a large cohort will reliably identify these different responders

Trial Locations

Locations (1)

University Hospital of Cologne

🇩🇪

Cologne, Germany

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